Abstract
Objectives To identify factors associated with mortality in cases with Alzheimer's disease (AD) and vascular dementia (VD), we conducted a seven-year follow-up study.
Methods Subjects were recruited through three agents in Yamanashi prefecture. A total of 145 patients (56 men, 89 women, age at baseline 77±7.9, 80±8.5 years respectively) with AD and VD participated in the follow-up study. We analyzed the relationship between demographic or clinical variables and their survival using a Cox regression model.
Results The analysis revealed that increased age, male gender, the degree of global function and past history of a fall/fracture were associated with a decreased survival rate. The rate was worse for patients with VD than for those with AD.
After adjusting for age and gender, the mortality risk ratio was 1.7 (95% confidence interval 1.1-2.6) for the presence of a fall/fracture. The same analysis confined to 64 subjects for whom ApoE genotyping data were available replicated the results; a fall/fracture was a predictor of a worse survival rate. In addition, those with ApoE4 tended to have better survival rate than those without (P<0.1).
Conclusion Those who are engaged in care for AD patients should appreciate the importance of a fall/fracture as a predictor of survival.
